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SJLHD - UND ROUND 'TANK CLOSURE/AltANDU NT INSPEC'TIUN <br /> (SHADED AR TO BE FILLED IN FOR THE ;NT TANK ONLY) <br /> 4% aD!4. <br /> cu a <br /> EOWNER AME OWNER PHONE <br /> N CONTRACTOR CON. PHONEN <br /> q E <br /> R < SJLHD PERMIT I EPA 3# FIRE PERMIT .9 <br />#, <br /> L � � � . <br /> 7 <br />} INSPECTOR DATE =TANK 1 39 - - <br /> R RINSED (Y/N) METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHOD AMOUNT USED <br /> _ A <br /> P L.E.L. READING AT REMOVAL (MUST BE C 20%) <br /> 0 <br /> T RJI COMMENTS <br /> =A <br /> N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> V 0O TANK CONDITION (GOOD, POOR, HOLES) <br /> � P N <br /> I IT <br /> PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) FEET <br /> P <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> F A a <br /> G <br /> �..' I N ea s <br /> ce <br /> E K tl <br /> D 3- <br /> AV <br /> EX ATION SIZE: I D X X YDS OF SOIL: a <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE t <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> i <br /> Q H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 I OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: <br /> LABORATORY: L & /7ni Cc�,Q SAMPLERS NAME: <br /> CLOSURE IN PLACE IXTURE: VOLUME: <br /> DRAW SITE MAP ON KEVERSE <br /> Ell 23 0,33(7/88) <br />